The purpose of this study was to analyze the gap between importance and performance in perceived sanitation management for general hospital foodservice operations. Data were collected through surveys given to 168 hospital dietitians in the Seoul-Incheon, Gyeonggi-do, Daegu, and North Gyeongsang province. The 65 questionnaires from total questionnaires were usable and the response rate was 38.7%. All statistical analyses were conducted using the SPSS package program (version 20.0) for t-test, ANOVA, and importance-performance analysis (IPA). According to the importance and performance analysis for 26 items, the importance score was significantly higher than the performance score for 22 items. In addition, the results of IPA showed the following areas as improvement priorities: handling foods on working table and management of distribution temperature. In conclusion, the performance level of prerequisite programs applying to the hospital foodservice needs improvement, especially cross-contamination prevention and temperature control for distribution. Additionally dietitians should be educated about sanitation management items that perceived to be less important than the others.